Key result
In patients with left atrial myxoma, cerebral embolism was associated with a significantly longer duration of symptoms prior to diagnosis compared to nonembolism (105 vs 23 days; P<0.01).
Why the study?
Does the presence of cerebral embolism in patients with left atrial myxoma correlate with symptom duration, morphologic characteristics, and clinical outcomes?
Observational (n=78)
Does the presence of cerebral embolism in patients with left atrial myxoma correlate with symptom duration, morphologic characteristics, and clinical outcomes?
Absolute Event Rate: 105% vs 23%
p-value: p=<0.01
Patients with left atrial myxoma who experience cerebral embolism have a longer duration of symptoms and are more likely to have irregular, soft (type 1) tumors, emphasizing the need for early diagnosis and surgical resection.
Prolonged symptoms may heighten embolism risk in left atrial myxoma; hypothesis-generating for morphology-outcome links.
The aim of this study was to evaluate the embolic sequelae of left atrial myxomas and their influence on diagnosis, treatment, and prognosis. Seventy-eight patients were retrospectively investigated. According to their symptoms and neurologic-imaging findings, these patients were classified into 2 groups: embolism (15 patients, 19%) and nonembolism (63 patients, 81%). The time from the first onset of symptoms to diagnosis (that is, the duration of symptoms) was significantly longer in the embolism group than in the nonembolism group (105 ± 190 vs 23 ± 18 d; P <0.01). The myxomas were divided into 2 types on the basis of clinicopathologic findings: type 1, with an irregular or villous surface and a soft consistency, and type 2, with a smooth surface and a compact consistency. There were 42 patients with type 1 myxoma and 36 with type 2. Type 1 myxoma was more frequently found in the embolism group (12 patients, 29%) than was type 2 myxoma (3 patients, 8%). The difference was significant (P=0.04). There were 2 perioperative deaths in the nonembolism group. No recurrence of cardiac myxoma or death was recorded in either group during follow-up. In the embolism group, neurologic symptoms were relieved by surgery, and no subsequent neurologic event was reported. Because surgical resection is highly effective in left atrial myxoma, we should strive for early diagnosis in order to shorten the duration of symptoms and to avoid worse neurologic damage in patients in whom an embolic event is the initial manifestation.
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Zheng et al. (2014) conducted an observational in Left atrial myxoma (n=78). Cerebral embolism vs. Nonembolism was evaluated on Time from the first onset of symptoms to diagnosis (duration of symptoms) (p=<0.01). In patients with left atrial myxoma, cerebral embolism was associated with a significantly longer duration of symptoms prior to diagnosis compared to nonembolism (105 vs 23 days; P<0.01).
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